Sun June 24, 2012

Dr. Karp On Parenting And The Science Of Sleep

Dr. Harvey Karp is on the faculty of the University of Southern California's School of Medicine. His other books include The Happiest Baby on the Block and The Happiest Toddler on the Block.

Courtesy of HarperCollins

The key to being a new parent, says renowned pediatrician Dr. Harvey Karp, is to think of your newborn's "fourth trimester."

"Our babies aren't like horses. They can't run the first day of life," Karp says. "And so we need to recognize that they're evicted from the womb three months before they're ready for the world."

Karp's series of parenting books, The Happiest Baby, are international best sellers. He's treated thousands of kids during his 30-year career, including the children of celebrity parents from Madonna to Pierce Brosnan, and developed a universal system for quieting fussy infants.

It's called the "5 S's": swaddling, side or stomach position, shushing, swinging, and sucking. Those five actions re-create the atmosphere in the womb — the "fourth trimester."

"In the first three or four months of life, those are like a magic potion for them," Karp says.

He spoke with weekends on All Things Considered host Guy Raz about the 5 S's, the science of sleep and what new parents often get wrong.

Interview Highlights

On the importance of sleep — for everyone:

"It's the No. 1 complaint parents have. And it isn't that they're being weak or wussy. I mean, the fact of the matter is the military uses sleep deprivation to train Navy SEALs to endure torture. It's one of the main triggers for postpartum depression. You get more illnesses. Your immune system is knocked down. Of course, you're irritable and you have more marital stress when that happens. So it has a lot of burden on families, beyond the fact that you're tired."

On why noise is so important for babies:

"The womb is louder than a vacuum cleaner, 24/7. And so to put them in a quiet room and tiptoe around seems like it's the right idea — actually, it's sensory deprivation. It drives them crazy. It's a wonder that any of them sleep in a quiet room. And so one of the things that can be a help is to use white noise. Because what happens it that you think while you're sleeping. The white noise literally competes with your thinking. So it helps kids — and adults, for that matter — be able to stay in a better level of sleep."

How early childhood parenting has changed in the U.S.:

"We've kind of gone through a cycle [in the past 20 years] where parents have gotten very good at doing well in school, doing well in the workplace and having these more mature kind of methods for dealing with people. Unfortunately, when you take those business methods to work with a toddler, it can lead to conflicts. And so I think that one of the big changes that has occurred is that parents have lost their way in terms of being able to have good relations with their young kids — and have kind of an intuitive approach to how they should speak and what they should expect."

On how to speak to toddlers — 'Toddlerese':

"Toddlers are like cavemen. They're uncivilized. A 9-month-old is not born knowing how to say 'please' and 'thank you' and wait in line and share their toys. We have to teach that to our toddlers. But one of the biggest mistakes parents make is when their toddler is upset. We tend to speak to them almost like mini-psychiatrists. The more upset they get, we go, 'Sweetheart, it's OK. Calm down. Calm down. Calm down.' And what that feels like when you're very upset? Is patronizing. Like, 'You don't really understand how I feel. You're just trying to make me stop talking.' And so with a very simple change in technique where you use short phrases, repetition, and mirroring a third of their feeling — I call it 'Toddlerese' — so when your child is upset, [you might say], 'You don't like it! You say no! No! No! You don't want to do that! Your face is sad and you don't want to go with Mommy right now!' And what happens is they start to calm down because they feel acknowledged. And then you get to your message. 'Honey, we have to go. Daddy's waiting.'"

The biggest misconception new parents have:

"That you're going to have control. We're so used to having control in our lives. Once you have a child, suddenly that control is taken away from you. That's a real shocker for people with young children. You ultimately have to make the decisions, obviously. But young children do need respect and they need to have some opportunities to make decisions so that they can grow up and learn how to do that. This idea that you've got all the answers, all the control — that's something that I think is a shock for parents."

Copyright 2012 National Public Radio. To see more, visit http://www.npr.org/.

Transcript

GUY RAZ, HOST:

It's WEEKENDS on ALL THINGS CONSIDERED from NPR News. I'm Guy Raz.

Pediatrician Harvey Karp has treated thousands of children over the course of his 30-year-career. That includes the kids of celebrities like Madonna and Pierce Brosnan. And his popular series of parenting books, "The Happiest Baby," are international bestsellers. His latest book is called "The Happiest Baby Guide to Great Sleep." And if you're a parent, you know we're really talking about your sleep.

DR. HARVEY KARP: Well, it's the number one complaint parents have. And it isn't that they're being, you know, weak or wussy. I mean, the fact of the matter is, the military uses sleep deprivation to train Navy SEALs to endure torture, because it's one of the main triggers for post-partum depression. You get more illnesses. Your immune system is knocked down. Of course, you're irritable, and you have more marital stress when that happens. So it has a lot of burden on families beyond the fact that you're tired.

RAZ: You are best known - anybody listening to this who has had a child in the last five years knows who Harvey Karp is because he probably received one or two or - in my case, five copies of his DVD...

(LAUGHTER)

RAZ: ...from friends of mine - "The Happiest Baby on the Block," which is basically a method to quiet your kid. The five Ss. This is what you're famous for. So for people who don't know what those are, tell me what the five Ss are.

KARP: So it turns out calming a crying baby is oftentimes as simple as turning on their calming reflex. That's a reflex all babies are born with. That's kind of an off switch for crying and an on switch for sleep. And the way you turn that on is by doing these five steps that imitate the womb. It's swaddling, which is snug wrapping, the side or stomach position, never for sleep. The back is the only position for sleep, but it's the worst position for a crying baby. The third is shushing or white noise, the fourth is swinging or rhythmic motion, and the fifth is sucking.

And every kid's a little bit different. But you layer those on, and in the first three or four months of life, those are like a magic, you know, potion for them.

RAZ: Do you know how many times I was crouched over with my child on his side going sshh at 2 a.m.? And it's strange because you actually - the way I did it was not as loud as you suggest.

KARP: Mm-hmm.

RAZ: You suggested you do it quite loud.

KARP: Well, you do it as loud as they're crying, really.

RAZ: Yeah.

KARP: And the sound in the womb is louder than a vacuum cleaner 24/7.

RAZ: The idea that you have is that when a baby is born they enter the fourth trimester.

KARP: Right. So in other words, our babies aren't like horses. They can't run the first day of life.

RAZ: Right.

KARP: They're very immature. It's amazing. By three months of age, they're ready to do the most important thing a human being ever does, which is develop social relations. You smile, they smile.

RAZ: They smile.

KARP: You coo, they coo. But they can't do that in the first couple of months. And so we need to recognize that they're evicted from the womb three months before they're ready for the world. So even if you hold them 12 hours a day, that's a big cutback from the 24 hours a day they were used to.

And this noise thing is an important part of it, too, because in the womb, the sound is loud. And so to put them in a quiet room and tiptoe around seems like that's a right idea, actually, it's sensory deprivation. It drives them crazy. It's a wonder that any of them sleep in a quiet room.

And so one of the things that can be a help is to use white noise because what happens is that you think while you're sleeping. The white noise literally competes with your thinking. It certainly competes with other sounds on the street, trucks and planes and things like that, that can disturb you, but it even competes with your own thinking. So it helps kids and adults, for that matter, be able to stay in a better level of sleep.

RAZ: Let's talk about some myths that you want to dispel. One of the myths is never wake a sleeping baby.

KARP: Right.

RAZ: Why would you want to wake a sleeping baby?

KARP: Well, the fact of the matter is that one of the things we have to teach babies is how to be able to put themselves to sleep on their own. What you're hoping is that when your little baby wakes up at 3 a.m., if they're not hungry or they're not in pain or something, they have the capability of putting themselves back to sleep.

If you always rock and feed your baby until they're in this blissful state, and then you gently put them into the bed, then they've never learned that ability. So there's a technique called wake/sleep where you feed your baby - don't worry if your baby falls asleep in your arms. That's fine. But when you do put the baby in bed, and they're drunk from the milk anyway at that point, you kind of slide them in bed swaddled with the white noise playing and you literally wake them up, they look around for five or 10 seconds and fall asleep. And in those 10 seconds, they're learning how to self-soothe.

RAZ: How has early childhood parenting changed over the course even of your career, you know, let's say over the last 20 or so years in the United States, dramatically?

KARP: We've kind of gone through a cycle where parents have gotten very good at doing well in school, doing well in the workplace and having these more mature kind of methods for dealing with people. Unfortunately, when you take those business methods to work with a toddler, it can lead to conflicts. And so I think that one of the big changes that's occurred is that parents have lost their way in terms of being able to have good relationships with their young kids and have kind of an intuitive approach to how they should speak and what they should expect.

What I talk a lot about is how you need to speak to your child in kind of a different language. The toddlers, in an odd sort of a way, are like cavemen. They're uncivilized. Matter of fact, your job - and you know this. You've got two kids. A 9-month-old is not born knowing how to say please and thank you and wait in line and share their toys. We have to teach that to our toddlers. But what is one of the biggest mistakes parents make is when their toddlers are upset, we tend to speak to them almost like we're like mini-psychiatrists.

The more upset they get, we go, sweetheart, it's OK. It's OK. Calm down. Calm down. Calm down, like we're talking them off out of jumping off a bridge or something. And what that feels like when you're very upset is it feels patronizing.

Like, you don't really understand how I feel. You're just trying to make me stop talking. And so with a very simple change in technique, where you use short phrases, repetition and mirroring a third of their feeling - I call it toddlerese - so when your child is upset, it might be something like, you don't like it. You say: No, no, no. You don't want to do that. Your face is sad, and you're - you don't want to go with Mommy right now.

And what happens is they start to calm down, because they feel acknowledged, and then you say, but, honey, we have to go, daddy's waiting, you know, and then you get to your message. And this isn't magic. It doesn't work 100 percent of the time. But probably 50 percent of the time you can stop a young child's temper tantrums as young as a year of age, because what they're trying to do is just get you to understand what it is they're feeling. And they just want to be acknowledged.

RAZ: What do you think is the biggest misconception you hear about parenting? Like, what do people think parenting is - maybe before they have a kid or if they don't have a kid - that is just not true?

KARP: Well, the biggest misconception, I think, is that you're going to have control in the situation. We're so used to having control in our lives. And even being pregnant, you kind of have control. You can make choices and do the things you want to do. Once you have a child, suddenly, that control is taken away from you. And that's a real shocker for people with young children.

You ultimately have to make the decisions, obviously. You're the last resort. But young children do need respect, and they do need some opportunities to make decisions so that they can grow up and learn how to do that. This idea that you've got all the answers, all the control, you know, that's something that I think is a shock for parents.

RAZ: That's the renowned pediatrician Dr. Harvey Karp. He's a fellow at the American Academy of Pediatrics. His new book is called "The Happiest Baby Guide to Great Sleep." You can also call it the happiest parent guide to great sleep.

KARP: Well, the whole family.

RAZ: Dr. Karp, thanks for joining us.

KARP: Thank you very much, Guy. Transcript provided by NPR, Copyright National Public Radio.